JP2002535069A - Tissue sample isolation and damage apparatus and method - Google Patents

Tissue sample isolation and damage apparatus and method

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Publication number
JP2002535069A
JP2002535069A JP2000595601A JP2000595601A JP2002535069A JP 2002535069 A JP2002535069 A JP 2002535069A JP 2000595601 A JP2000595601 A JP 2000595601A JP 2000595601 A JP2000595601 A JP 2000595601A JP 2002535069 A JP2002535069 A JP 2002535069A
Authority
JP
Japan
Prior art keywords
tissue sample
tissue
treatment
sample
cutting member
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
JP2000595601A
Other languages
Japanese (ja)
Inventor
フレッド・エイチ・バーバンク
ポール・ルボック
Original Assignee
セノークス・インコーポレイテッド
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by セノークス・インコーポレイテッド filed Critical セノークス・インコーポレイテッド
Publication of JP2002535069A publication Critical patent/JP2002535069A/en
Pending legal-status Critical Current

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Abstract

(57)【要約】 周辺組織内に配置された組織試料を処置するための本発明による装置及び方法は、組織試料単離用ツールと組織試料ダメージャーを有している。組織試料単離用ツールは、周辺組織から組織試料を単離する。一方、組織試料ダメージャーは、最終的な結果が壊死となり得る状態で、その組織にダメージを与える。その離断用ツールは、本装置の周囲の外向きに円弧状に撓んだ位置へ拡張可能な切断メンバーを有していてよい。組織試料の周囲でその切断メンバーを回転させることにより、該組織試料が単離される。切断メンバーは、切断メンバー高周波発生源に機能的に接続されていてよい。組織試料ダメージャーは、電離放射線、切断装置、熱的な処置装置、化学的な処置装置、もしくは、組織試料の外側境界のシーリングを用いて組織試料にダメージを与えることができる。 (57) SUMMARY An apparatus and method according to the present invention for treating a tissue sample disposed in a surrounding tissue includes a tissue sample isolation tool and a tissue sample damager. The tissue sample isolation tool isolates a tissue sample from surrounding tissue. On the other hand, the tissue sample damageer damages the tissue in a state where the final result can be necrosis. The severing tool may include a cutting member that is expandable to an outwardly bowed position about the device. The tissue sample is isolated by rotating the cutting member around the tissue sample. The cutting member may be operatively connected to a cutting member radio frequency source. The tissue sample damageer can damage the tissue sample using ionizing radiation, a cutting device, a thermal treatment device, a chemical treatment device, or sealing the outer boundary of the tissue sample.

Description

【発明の詳細な説明】DETAILED DESCRIPTION OF THE INVENTION

【０００１】 （技術分野） 本発明は、組織試料の処置に関するものであり、より詳細には生体内における
組織試料の処置に関するものである。TECHNICAL FIELD [0001] The present invention relates to treatment of tissue samples, and more particularly to treatment of tissue samples in vivo.

【０００２】 （背景技術） 先行技術は、周辺組織に留めたまま組織試料を単離する装置及び方法を開示し
ている。その先行技術はまた、生体内における非単離組織試料を切除する装置及
び方法、乃至はそれらに別の仕方でダメージを与える装置及び方法についても開
示している。しかしながらこの先行技術は、それらの２つの概念を一つの方法も
しくは装置に併合することに関しては開示しておらず、示唆もなく、また動機を
与えてもいない。更に述べれば、その先行技術は、それらの２つの概念を併合す
ることによる相乗効果について何も開示していない。BACKGROUND OF THE INVENTION The prior art discloses devices and methods for isolating a tissue sample while remaining in the surrounding tissue. The prior art also discloses an apparatus and method for ablating non-isolated tissue samples in vivo or otherwise damaging them. However, this prior art does not disclose, suggest, or motivate the merging of the two concepts into one method or device. Furthermore, the prior art does not disclose anything about the synergistic effect of merging the two concepts.

【０００３】 T. Lorentzenらによる「ループ電極：高周波電気外科を用いる、US−指導（US
-guided）間質組織切除のための新たな装置−動物実験（The Loop Electrode: A
New Device For US-guided Interstitial Tissue Ablation Using Radiofreque
ncy Elecrosurgery - An Animal Study）」（Min Invas Ther & Allied Technol
1996: 5: 511-516）と題する論文では、高周波ループを用いて間質組織切除を
実施する技術が開示されている。そこでは、この装置を仔ウシの肝臓に挿入し、
回転させて病変部を間質的に切除する手順が示されている。この論文では、術中
性冷凍外科などのように侵襲性が極めて低い組織切除技法や、レーザー、マイク
ロ波、高周波電気外科、及びエタノールまたは高温生理食塩水の注入等の経皮的
方法について検討している。また、この論文は、非侵襲的な方法の一例として集
束性の高い超音波についても検討している。しかし、この論文は、高周波ループ
を他の組織切除法と組み合わせて使用することに関しては開示しておらず、示唆
もなく、また動機を与えてもいない。[0003] T. Lorentzen et al., "Loop Electrodes: US-Teaching Using High-Frequency Electrosurgery.
-guided) New device for stromal tissue resection-Animal experiment (The Loop Electrode: A
New Device For US-guided Interstitial Tissue Ablation Using Radiofreque
ncy Elecrosurgery-An Animal Study) "(Min Invas Ther & Allied Technol
A paper entitled 1996: 5: 511-516) discloses a technique for performing interstitial tissue resection using a high-frequency loop. There, this device was inserted into the calf ’s liver,
The procedure for interstitial resection of the lesion by rotation is shown. In this paper, we examine extremely invasive tissue ablation techniques such as intraoperative cryosurgery and percutaneous methods such as laser, microwave, radiofrequency electrosurgery, and injection of ethanol or high-temperature saline. I have. The paper also discusses highly focused ultrasound as an example of a non-invasive method. However, the article does not disclose, suggest, or motivate the use of high frequency loops in combination with other tissue resection methods.

【０００４】 C. Nolsoeらによる「ディフューザーチップを備えたUS−指導（US-guided）Nd
−YAGレーザーを用いる結腸直腸性肝臓転移の間質性高熱：試験的臨床試験（Int
erstitial Hyperthermia Of Colorectal Liver Metastases With A US-guided N
d-YAG Laser with a Diffuser Tip: A pilot Clinical Study）」（Radiology,
1993; 187: 333-337）と題する論文には、腫瘍の中心にレーザーファイバーを配
置し、高熱切除を行うのにその腫瘍にレーザーを照射するステップを含む手順が
開示されている。またこの論文では、当該方法の使用中にその腫瘍の温度をモニ
ターするために超音波を使用することも開示されている。この論文は、その組織
試料周囲の黒化境界領域と、その黒化境界を越える凝固領域を開示している。し
かし、この論文は、非単離組織試料の切除と組み合わせることに関しては何も開
示していない。即ち、この論文は、レーザーの使用を他の組織切除法と組み合わ
せて使用することに関しては開示しておらず、示唆もなく、また動機を与えても
いない。[0004] US-guided Nd with diffuser tips by C. Nolsoe et al.
-YAG Laser Interstitial Hyperthermia of Colorectal Liver Metastases: An Experimental Clinical Trial (Int
erstitial Hyperthermia Of Colorectal Liver Metastases With A US-guided N
d-YAG Laser with a Diffuser Tip: A pilot Clinical Study ”(Radiology,
1993; 187: 333-337) disclose a procedure that involves placing a laser fiber in the center of a tumor and irradiating the tumor with a laser to perform a hyperthermic ablation. The article also discloses the use of ultrasound to monitor the temperature of the tumor during use of the method. The article discloses a blackened boundary region around the tissue sample and a solidified region beyond the blackened boundary. However, this article does not disclose anything in combination with excision of non-isolated tissue samples. That is, the article does not disclose, suggest, or motivate the use of lasers in combination with other tissue resection methods.

【０００５】 S. G. Brownによる「腫瘍の光線療法（Photothrapy of Turmrs）」（World J.
Surg. 7, 700-709, 1983）と題する論文には、腫瘍の治療法として色素レーザ
ーと共に化学的なヘマトポルフィリン誘導体（HpD）を使用する方法が開示され
ている。このHpD／色素レーザー法は、殆どのレーザー法で見られるような熱的
なものではなく、活性化されたHpDによる一重項酸素の生成に基づくものである
。この論文は、HpD／色素レーザー法が有望であることを開示しているが、処置
に先立ってその組織試料を単離することに関しては開示しておらず、示唆もなく
、また動機も与えていない。この論文は、熱的なレーザー法の実施中に周辺組織
へ及ぼす受け入れがたいダメージに関わる問題について明らかにしている。“Photothrapy of Turmrs” by SG Brown (World J.
Surg. 7, 700-709, 1983) discloses the use of a chemical hematoporphyrin derivative (HpD) with a dye laser as a treatment for tumors. This HpD / dye laser method is not thermal as in most laser methods, but is based on the production of singlet oxygen by activated HpD. Although this article discloses the promise of the HpD / dye laser method, it does not disclose, suggest, or motivate the isolation of tissue samples prior to treatment. Absent. This paper highlights the issues involved in unacceptable damage to surrounding tissue during thermal laser techniques.

【０００６】 F. K. Stromらによる「臨床温熱化学療法：進行した癌患者における管理試験
（Clinical Thermochemotherapy : A Controlled Trial In Advanced Cancer Pa
tients）」（Cancer 53 : 863-868, 1984）と題する論文には、癌細胞の薬剤取
り込みを高めるため、高熱と化学療法を組み合わせる方法が開示されている。そ
こでは、マグネトロード磁気−ループ誘導装置（a magnetrode magnetic-loop i
nduction device）を用いて高熱が与えられている。この論文は、その組織試料
を取り巻く組織を保護することの有益性を示しており、そこに開示されている方
法では、この保存が、同時的な血管閉塞により行われる。この論文では、他の組
織試料切除法と組み合わせて、組織試料と周辺組織との間の血管接続を離断する
直接的な方法を開示しておらず、動機付けもなく、また示唆も与えていない。[0006] FK Strom et al., "Clinical Thermochemotherapy: A Controlled Trial In Advanced Cancer Pa
The paper entitled "Tients" (Cancer 53: 863-868, 1984) discloses a method of combining hyperthermia and chemotherapy to enhance drug uptake by cancer cells. There, a magnetrode magnetic-loop induction device (a magnetrode magnetic-loop i
high heat is applied using an induction device. This article shows the benefits of protecting the tissue surrounding the tissue sample, and in the method disclosed therein, this preservation is achieved by simultaneous vascular occlusion. This paper does not disclose, motivate, or suggest any direct method of breaking the vascular connection between a tissue sample and surrounding tissue in combination with other tissue sample resection methods. Absent.

【０００７】 S. L. Jacquesらによる「ダイオードレーザー（８０５ｎｍ）対Ｎｄ：ＹＡＧ
レーザー（１０６４ｎｍ）による肝臓の光凝固術（Liver Photocoagulation Wit
h Diode Laser (805nm) Vs Nd: YAG Laser (1064nm)」（SPIE Vol. 1646 Laser-
Tissue Interaction III (1992), p. 107-117）と題する論文には、レーザー療
法が放射状に広がる領域の組織にダメージをもたらすことが開示されている。し
かし、この論文は、壊死の標的となる組織試料の単離や、周辺組織へ及ぼすダメ
ージの低減を伴ってもたらされ得る結果については開示しておらず、示唆もなく
、また動機を与えてもいない。[0007] Diode laser (805 nm) vs. Nd: YAG by SL Jacques et al.
Liver Photocoagulation Wit with laser (1064nm)
h Diode Laser (805nm) Vs Nd: YAG Laser (1064nm) ”(SPIE Vol. 1646 Laser-
A paper entitled Tissue Interaction III (1992), p. 107-117) discloses that laser therapy causes damage to tissue in radially extending areas. However, the paper does not disclose, suggest, or motivate the consequences of isolating a tissue sample targeted for necrosis or reducing the damage to surrounding tissue. Not even.

【０００８】 F. A. Joleszによる「レーザー−組織相互作用のＭＲイメージング（MR Imagi
ng Of Laser-Tissue Interactions）」（Radiology 1988; 168: 249-253）と題
する論文には、高熱処置中に熱の伝達と周辺組織へのダメージをモニターすべき
であることが開示されている。また、この論文では、他のパラメーターの中でも
特に循環冷却がエネルギーデポジションに影響を及ぼすことも開示している。し
かし、この論文は、高熱処置に先立って組織試料を単離することに関しては開示
しておらず、示唆もなく、また動機を与えてもいない。この情報は、同様に、D.
L. Bihanによる「分子拡散のＭＲイメージングを用いる熱地図作成：高熱への
適用（Temperture Mapping With MR Imaging Of Molecular Diffusion: Applica
tion to Hyperthermia）」（Radiology 1989; 171: 853-857）と題する論文にも
開示されている。[0008] MR imaging of laser-tissue interaction by FA Jolesz (MR Imagi
The paper entitled “ng Of Laser-Tissue Interactions” (Radiology 1988; 168: 249-253) discloses that heat transfer and damage to surrounding tissue should be monitored during hyperthermic treatment. The paper also discloses that, among other parameters, circulating cooling affects energy deposition. However, the article does not disclose, suggest, or motivate the isolation of tissue samples prior to hyperthermic treatment. This information is also available from D.
L. Bihan, "Temperture Mapping With MR Imaging Of Molecular Diffusion: Applica
tion to Hyperthermia) (Radiology 1989; 171: 853-857).

【０００９】 このように、先行技術は、処置すべき組織試料を取り巻く組織にダメージが生
じることを明らかにしている。従って、必要とされているものは、その周辺組織
へのダメージを低減するための装置及び方法である。また、その組織試料に高い
効率でダメージを与えられる装置及び方法も求められている。[0009] Thus, the prior art has shown that damage occurs to the tissue surrounding the tissue sample to be treated. Therefore, what is needed is an apparatus and method for reducing damage to surrounding tissue. There is also a need for an apparatus and method that can damage the tissue sample with high efficiency.

【００１０】 （発明の開示） 本発明の一つの態様では、周辺組織内に配置されている組織試料が処置される
。その処置は、単離ステップとダメージングステップを含む。単離ステップでは
、少なくとも周辺組織から組織試料を部分的に離断することにより、組織試料が
周辺組織から単離される。次に、その組織試料にダメージが与えられる。DISCLOSURE OF THE INVENTION In one aspect of the invention, a tissue sample located in surrounding tissue is treated. The treatment includes an isolation step and a damaging step. In the isolation step, the tissue sample is isolated from the surrounding tissue by at least partially dissecting the tissue sample from the surrounding tissue. Next, the tissue sample is damaged.

【００１１】 本発明のある態様では、単離ステップは、更に、その組織試料の周りで組織試
料単離用ツールを動かすステップを含む。本発明の更なる態様では、組織試料単
離用ツールは高周波エネルギーで活性化されたワイヤー（a radio frequency en
ergized wire）を含んでいる。その処置プロセスは、高周波エネルギーがチャー
ジされたツールを組織試料に適用するステップを含んでいてよい。In one aspect of the invention, the isolating step further comprises moving a tissue sample isolation tool about the tissue sample. In a further aspect of the invention, the tool for tissue sample isolation comprises a radio frequency energized wire.
ergized wire). The treatment process may include applying a radio frequency charged tool to the tissue sample.

【００１２】 本発明の態様では、ダメージングステップは、組織試料に電離放射線を適用す
るステップ、組織試料を切断するステップ、組織試料を熱的に処置するステップ
、組織試料を化学的に処置するステップ、もしくは組織試料の外側の境界をシー
リングするステップを含んでいてよい。In an aspect of the invention, the damaging step includes applying ionizing radiation to the tissue sample, cutting the tissue sample, thermally treating the tissue sample, and chemically treating the tissue sample. Or sealing the outer boundary of the tissue sample.

【００１３】 本発明の一つの態様では、周辺組織内の組織試料を処置するための装置は、作
用部、組織離断用ツール及び組織試料ダメージャーを含んでいる。その組織試料
単離用ツールと組織試料ダメージャーは作用部に配置されている。In one aspect of the invention, an apparatus for treating a tissue sample in surrounding tissue includes a working portion, a tissue transection tool, and a tissue sample damager. The tissue sample isolation tool and the tissue sample damageer are arranged in the working section.

【００１４】 本発明の更なる態様では、その組織試料単離用ツールに高周波発生源が機能的
に（functionally）接続されている。In a further aspect of the invention, a radiofrequency source is operatively connected to the tissue sample isolation tool.

【００１５】 本発明のある態様では、処置装置の組織試料単離用ツールは、その作用部の周
りに外方へ円弧状に撓んだ位置（an outwardly radially bowed position）へ拡
張可能な切断メンバーを含んでいる。本発明の更なる態様では、その切断メンバ
ーに切断メンバー高周波発生源が機能的に接続されている。[0015] In one aspect of the invention, the tissue sample isolation tool of the treatment device includes a cutting member that is expandable to an outwardly radially bowed position about its working portion. Contains. In a further aspect of the invention, a cutting member radio frequency source is operatively connected to the cutting member.

【００１６】 本発明の一つの態様では、処置装置の組織試料ダメージャーは、その作用部か
ら伸び、且つ、金属メンバー高周波発生源に機能的に接続可能な少なくとも一つ
の金属メンバーを含んでいる。In one aspect of the invention, a tissue sample damageer of a treatment device includes at least one metal member extending from its working portion and operably connected to a metal member radio frequency source.

【００１７】 本発明の態様では、組織試料ダメージャーは、電離放射線導波器、組織試料カ
ッター、熱処置システム、または化学物質導入システムを含んでいてよい。In aspects of the invention, the tissue sample damageer may include an ionizing radiation waveguide, a tissue sample cutter, a thermal treatment system, or a chemical introduction system.

【００１８】 （好適な実施態様の説明） 次に、図面を参照しながら説明する。特に図１を参照すると、組織試料の単離
並びにダメージング装置１０は、右側に示されている近位側端部１４と左側に示
されている遠位側端部１６を有する棒状部１２を含んでいる。この装置１０は、
組織試料を周辺組織内に配置されている状態でその組織試料を単離し、次いで、
該組織試料にダメージを与えるために使用される（図２及び図３を参照）。単離
ステップは、循環系（circulation）からその組織試料を単離するステップ、及
び／又は、周辺組織から該組織試料をあまねく離断するステップを含んでいてよ
い。ダメージングステップの後、その組織試料は、体内に留まり、線維症組織と
なり、及び／又は、当該プロセス中に、もしくは後の段階で体内から取り除くこ
とができる。(Description of Preferred Embodiment) Next, a description will be given with reference to the drawings. With particular reference to FIG. 1, the tissue sample isolation and damaging device 10 includes a rod 12 having a proximal end 14 shown on the right and a distal end 16 shown on the left. Contains. This device 10
Isolating the tissue sample while the tissue sample is located in the surrounding tissue;
Used to damage the tissue sample (see FIGS. 2 and 3). The isolation step may include isolating the tissue sample from the circulation and / or generally detaching the tissue sample from surrounding tissue. After the damaging step, the tissue sample remains in the body, becomes fibrotic tissue, and / or can be removed from the body during the process or at a later stage.

【００１９】 単離中に、組織試料が壊死状態になってもよく、本装置１０は、確実に壊死が
起こるように当該組織試料にダメージを与える。組織試料の壊死は、その組織試
料から悪性組織または罹患組織が転移する危険性の低減ないし排除をもたらす。
また、組織試料の壊死は、患者の生体に当該組織試料の回復を止めさせる。図示
されている本発明の実施態様は、高周波発生器１８を用いてこの手順を実施する
。本発明の他の実施態様では、幾つかの例が以下で包括的に検討される他の方法
を用いてもよい。During isolation, the tissue sample may become necrotic, and the apparatus 10 damages the tissue sample to ensure that necrosis occurs. Necrosis of a tissue sample results in a reduction or elimination of the risk of metastasis of malignant or diseased tissue from the tissue sample.
Necrosis of a tissue sample also causes the patient's organism to stop recovering the tissue sample. The illustrated embodiment of the present invention uses a high frequency generator 18 to perform this procedure. In other embodiments of the present invention, some examples may use other methods as discussed comprehensively below.

【００２０】 棒状部１２の遠位側端部１６に本装置１０の作用部２０が配置されている。作
用部２０は、組織試料の単離とダメージングの両方に関与する。図示されている
実施態様では、外方へ円弧状に撓んだワイヤー２２が組織試料を単離する。ワイ
ヤー２２は作用部２０に配置されており、棒状部１２に回転可能に接続されてい
る。図示されている本発明の実施態様では、ワイヤー２２は、本装置１０を配置
する際にもたらされる周辺組織への外傷を低減するため、当初は、棒状部１２に
対して引っ込んだ位置にある（図示せず）。作用部２０が当該組織試料またはそ
の近傍に配置された後、ワイヤー２２は外方へ円弧状に拡張される。The working section 20 of the device 10 is arranged at the distal end 16 of the rod section 12. The action section 20 is involved in both isolation and damage of a tissue sample. In the embodiment shown, the outwardly arcuately bent wire 22 isolates the tissue sample. The wire 22 is disposed on the action section 20 and is rotatably connected to the rod section 12. In the illustrated embodiment of the present invention, the wire 22 is initially in a retracted position relative to the bar 12 to reduce trauma to surrounding tissue that may result from placement of the device 10 ( Not shown). After the action section 20 is placed at or near the tissue sample, the wire 22 is expanded outward in an arc shape.

【００２１】 本装置１０の組織試料単離用ツールであるワイヤー２２は、高周波発生器１８
により活性化され、回転されて当該組織試料を単離する。ワイヤー２２が回転さ
れると、組織試料と周辺組織との間に外縁溝（図２参照）が形成され、このよう
にして、それらの２つの組織が離断される。本発明の他の実施態様では、ワイヤ
ー２２を固定して回転できないように棒状部１２に接続し、その撓んだワイヤー
２２だけを回すのではなく、該棒状部全体を回転させて当該組織試料を単離する
ようにしてもよい。The wire 22, which is a tissue sample isolation tool of the present apparatus 10, is connected to the high frequency generator 18.
Activated and spun to isolate the tissue sample. As the wire 22 is rotated, an outer edge groove (see FIG. 2) is formed between the tissue sample and the surrounding tissue, thus separating the two tissues. In another embodiment of the present invention, the wire sample 22 is connected to the rod portion 12 so that the wire sample 22 is not fixed and cannot be rotated, and the entire rod portion is rotated instead of turning only the bent wire 22. May be isolated.

【００２２】 本発明の実施態様は、１９９９年９月１０日に発行されたWO９９／４４５０６
号に開示されているもの等の切断メンバーを有する他の組織試料単離用ツールを
含んでいてよい。また、本発明の実施態様は、周辺組織から組織試料を部分的に
のみ離断するものであってもよい。An embodiment of the present invention is described in WO 99/44506, issued on September 10, 1999.
Other tissue sample isolation tools having cutting members, such as those disclosed in US Pat. Further, the embodiment of the present invention may be one in which the tissue sample is only partially cut off from the surrounding tissue.

【００２３】 遠位側端部１６には、棒状部１２を周辺組織へ挿入するステップ中にエネルギ
ー活性化される高周波ワイヤー２４が設けられている。他の実施態様は、エネル
ギー非活性化型の穴開け用ツール、もしくは、他の形態のエネルギー活性化型穴
開け用ツール等、周辺組織へ棒状部を挿入するための他の手段を有していてよい
。更に本発明の別の実施態様は、遠位側端部１６に穴開け用ツールを有しておら
ず、前もって存在する進路を通じて周辺組織へ進入するものであってもよい。The distal end 16 is provided with a radio frequency wire 24 that is energy activated during the step of inserting the rod 12 into surrounding tissue. Other embodiments have other means for inserting the rod into the surrounding tissue, such as an energy-inactivated drilling tool or other forms of energy-activated drilling tools. May be. Yet another embodiment of the present invention may have no piercing tool at the distal end 16 and enter the surrounding tissue through a pre-existing path.

【００２４】 図示されている実施態様では、組織試料は、単離後に切除されるか、もしくは
他の仕方でダメージを与えられる（図３参照）。組織試料のダメージングは壊死
をもたらす。そのダメージは、細胞機能を崩壊させる電離放射線によりもたらさ
れるものであってよい。また、組織試料の切断、もしくは細分化除去等の機械的
な手段を通じて当該組織試料にダメージを与えてもよい。更に、組織試料のダメ
ージは、熱的または化学的な治療の結果であってもよい。In the illustrated embodiment, the tissue sample is excised or otherwise damaged after isolation (see FIG. 3). Damaging the tissue sample results in necrosis. The damage may be caused by ionizing radiation that disrupts cell function. Further, the tissue sample may be damaged through mechanical means such as cutting or fragmentation removal of the tissue sample. Further, damage to the tissue sample may be the result of thermal or chemical treatment.

【００２５】 図１への参照を続けると、本装置１０の作用部２０から拡張する高周波ワイヤ
ー２８を用いて当該組織試料にダメージが与えられる。それらのワイヤー２８は
、当初、棒状部１２内の引っ込んだ位置にあるか、あるいは、棒状部１２上に配
置されている。どちらの場合も、組織試料の単離前、単離中、もしくは単離後に
、それらのワイヤー２８は、図示されているように広げられて当該組織試料に進
入する。本発明の一つの好適な実施態様では、それらのワイヤー２８は棒状部１
２内に配置されており、そして、組織試料を単離する前に広げられる。それらの
広げられたワイヤー２８は本装置１０を組織試料に据え付け、これにより、結果
として試料のより精密な単離がもたらされる。本発明の他の実施態様は、本装置
１０を組織試料に据え付けるための他の方法もしくはメカニズムを有していてよ
い。With continued reference to FIG. 1, the tissue sample is damaged using the high-frequency wire 28 extending from the working section 20 of the device 10. The wires 28 are initially in a retracted position within the bar 12 or are disposed on the bar 12. In either case, before, during, or after isolation of the tissue sample, the wires 28 are unrolled and enter the tissue sample as shown. In one preferred embodiment of the invention, the wires 28 are
2 and spread before isolating the tissue sample. These unrolled wires 28 mount the device 10 on a tissue sample, which results in more precise isolation of the sample. Other embodiments of the present invention may include other methods or mechanisms for attaching the device 10 to a tissue sample.

【００２６】 本装置１０の組織試料ダメージャーを包含する高周波ワイヤー２８は、図示さ
れているように、棒状部１２の遠位側端部１６に向けて拡張している。本発明の
他の実施態様は、あらゆる適当な方向へ拡張するワイヤー２８を有していてよい
。図示されているように、それらのワイヤー２８は、ほぼ、円弧状に（radially
）撓んだワイヤー２２になるまで拡張しており、その結果、それらのワイヤー２
８は、組織試料全体に分配される。本発明の他の実施態様は、組織試料の一部へ
拡張するワイヤー２８を有していてもよい。The high frequency wire 28 containing the tissue sample damageer of the device 10 extends toward the distal end 16 of the bar 12 as shown. Other embodiments of the present invention may have wires 28 that expand in any suitable direction. As shown, the wires 28 are substantially arcuately (radially).
) The wires 2 have been extended to bend, so that their wires 2
8 is distributed throughout the tissue sample. Other embodiments of the present invention may have a wire 28 that extends to a portion of the tissue sample.

【００２７】 エネルギー活性化されると、それらの高周波ワイヤー２８は、組織試料内の水
分子に振動をもたらし、且つそれらを急速に気化させることにより、その組織試
料にダメージを与える。急速な気化は当該組織試料中の細胞の破壊をもたらし、
これにより、該試料にダメージを及ぼす。この急速な気化は、熱処置の一つの形
態である。それらの高周波ワイヤーは、単極性であってもよいし、二極性であっ
てもよい。When energized, the radio frequency wires 28 cause vibrations to the water molecules in the tissue sample and damage the tissue sample by rapidly evaporating them. Rapid vaporization results in destruction of cells in the tissue sample,
This causes damage to the sample. This rapid vaporization is a form of heat treatment. These high-frequency wires may be unipolar or bipolar.

【００２８】 処置後、それらのワイヤー２８を棒状部１２内へ引っ込めることができる。本
発明の他の実施態様では、それらのワイヤー２８を引っ込めずに広がったままと
し、周辺組織からその棒状部１２を抜き取る際に、それらのワイヤー２８が当該
組織試料からすべり出るようにしてもよい。それらのワイヤー２８が遠位方向に
傾いていることが、棒状部抜き取り中における当該組織試料からのそれらのすべ
り出しを容易化する。After the procedure, the wires 28 can be withdrawn into the bar 12. In other embodiments of the present invention, the wires 28 may be left unexpanded and retracted so that the wires 28 slide out of the tissue sample as the rod 12 is removed from the surrounding tissue. . The inclination of the wires 28 in the distal direction facilitates their sliding out of the tissue sample during bar removal.

【００２９】 組織試料の離断及び単離は、より管理された状態で、且つより簡単な試料のダ
メージングプロセスをもたらす。熱処置が為されるケースでは、非単離組織試料
は、該試料を通じる血液循環により冷却もしくは加熱される。単離組織試料の熱
処置は、血液循環の冷却効果または加熱効果と対抗しない。該試料を通じる血液
循環の効果と対抗することなく、その熱処置は、より短時間で、且つ、当該組織
試料そのものにより制限されたものとなる。更に、この単離は、周辺組織への熱
的なダメージを低減する。The transection and isolation of a tissue sample results in a more controlled and simpler sample damaging process. In cases where heat treatment is performed, the non-isolated tissue sample is cooled or heated by blood circulation through the sample. Thermal treatment of an isolated tissue sample does not oppose the cooling or heating effects of blood circulation. Without opposing the effects of blood circulation through the sample, the thermal treatment is shorter and limited by the tissue sample itself. In addition, this isolation reduces thermal damage to surrounding tissue.

【００３０】 棒状部１２の近位側端部１４にはコントロールシステム３０が機能的に接続さ
れている。図示されている実施態様では、このコントロールシステム３０により
切断用ワイヤー２２と高周波ワイヤー２８を操作する。本発明の幾つかの実施態
様では、組織試料及び周辺組織への棒状部１２の挿入、並びにそこからの抜き取
りを、このコントロールシステム３０により制御してもよい。コントロールシス
テム３０は、ワイヤー２２及び２８にエネルギーを供給する高周波発生器１８に
機能的に接続されている。円弧状に撓んだワイヤー２２が棒状部１２上の固定位
置にあるような本発明の実施態様では、コントロールシステム３０は、組織試料
を単離すべく棒状部１２を回転させる。本発明の他の実施態様では、装置のこれ
らのコンポーネントは手動で操作される。A control system 30 is operatively connected to the proximal end 14 of the bar 12. In the embodiment shown, the control system 30 operates the cutting wire 22 and the high-frequency wire 28. In some embodiments of the present invention, the control system 30 may control the insertion and withdrawal of the rod 12 into and from the tissue sample and surrounding tissue. Control system 30 is operatively connected to high frequency generator 18 that supplies energy to wires 22 and 28. In embodiments of the present invention where the arcuately bent wire 22 is in a fixed position on the bar 12, the control system 30 rotates the bar 12 to isolate a tissue sample. In another embodiment of the invention, these components of the device are operated manually.

【００３１】 次に、図２を参照すると、図示の如く、作用部２０が組織試料５２に配置され
た状態で、本装置１０が乳房５０に配置されている。この実施態様では、乳房５
０を周辺組織と見なすことができよう。その組織試料５２は、図中にクロスハッ
チングで示された腫瘍５４を含んでいる。切断用ワイヤー２２は、図で示されて
いるように、外向きに円弧状に撓んだ位置にある。その切断用ワイヤー２２は既
に回転しており、これにより、外縁溝５６が形成されていて、組織試料５２が単
離される。図示の如く、図２では高周波ワイヤー２８は広げられていないことに
注意のこと。本発明の好適な実施態様の一つでは、それらのワイヤー２８は、単
離に先立って当該組織試料５２内に広げられる。Next, referring to FIG. 2, the device 10 is placed on the breast 50 with the action section 20 placed on the tissue sample 52 as shown. In this embodiment, the breast 5
0 could be considered the surrounding tissue. The tissue sample 52 includes a tumor 54 indicated by cross-hatching in the figure. The cutting wire 22 is located at a position bent outward in an arc shape as shown in the figure. The cutting wire 22 has already been rotated, whereby the outer peripheral groove 56 is formed, and the tissue sample 52 is isolated. Note that, as shown, the high frequency wire 28 has not been expanded in FIG. In one of the preferred embodiments of the present invention, the wires 28 are spread within the tissue sample 52 prior to isolation.

【００３２】 次に、図３を参照すると、図２の組織試料５２に既にダメージが与えられてお
り、結果として、本装置１０による熱処置を通じてダメージを受けた組織試料６
０が生じる。図に示されているように、装置１０の高周波ワイヤー２８はその組
織試料６０内に広げられている。それらのワイヤー２８は既にエネルギー活性化
されており、その結果として、水分子の気化、組織試料を構成する細胞の破壊、
試料の加熱、及びそれの終局的なダメージングがもたらされている。その処置の
量及び時間は予め決定しておいてもよいし、あるいは、装置が、処置の完了時を
示すフィードバックシステム（図示せず）を含んでいてもよい。後続のステップ
で、装置１０は、高周波ワイヤー２８を装置１０内に引っ込めるにしても引っ込
めないにしても、乳房５０から取り除かれる。Next, referring to FIG. 3, the tissue sample 52 of FIG. 2 has already been damaged, and as a result, the tissue sample 6
0 results. As shown, the high frequency wire 28 of the device 10 has been spread within the tissue sample 60. These wires 28 are already energy activated, resulting in the vaporization of water molecules, destruction of the cells that make up the tissue sample,
Heating of the sample and its ultimate damage has been caused. The amount and time of the treatment may be predetermined, or the device may include a feedback system (not shown) to indicate when the treatment is complete. In a subsequent step, the device 10 is removed from the breast 50, with or without retracting the radio frequency wire 28 into the device 10.

【００３３】 次に、図４を参照すると、図表１００は、高周波装置を通じる熱処置の他に、
生体内の組織試料にダメージを与えるための可能な方法に関する包括的なリスト
である。熱処置１０２の形態として、レーザー、高温流体、寒冷流体、高周波エ
ネルギー及び他の電気外科技法、マイクロ波、集束超音波、機械的超音波、衝撃
波、抵抗加熱、液体または気体を用いる冷凍外科、焼灼術、及び加熱物体の適用
がリストアップされている。加熱物体の一例が、Husseinらに与えられた「局所
加熱適用医療用具（Localized Heat Applying Medical Device）」と題する米国
特許第４７７３４１３号（その全体が本明細書に参照として取り込まれている）
に開示されている。本発明の他の実施態様は、組織試料にダメージを与えるため
にあらゆる適当な熱処置システムを用いることができる。Referring now to FIG. 4, chart 100, in addition to heat treatment through a high frequency device,
1 is a comprehensive list of possible methods for damaging tissue samples in vivo. As a form of thermal treatment 102, lasers, hot fluids, cold fluids, radio frequency energy and other electrosurgical techniques, microwaves, focused ultrasound, mechanical ultrasound, shock waves, resistive heating, cryosurgery using liquids or gases, cautery Surgery and applications of heated objects are listed. One example of a heated object is U.S. Pat. No. 4,773,413 to Hussein et al. Entitled "Localized Heat Applying Medical Device," which is incorporated herein by reference in its entirety.
Is disclosed. Other embodiments of the present invention can use any suitable thermal treatment system to damage a tissue sample.

【００３４】 機械的処置手段のリスト１０４は、細分化除去装置及び他の切断装置を含む。
電離放射線処置手段のリスト１０６は、Ｘ線針を含むＸ線を用いる処置や、ガン
マ線を用いる処置及び電離放射線導波器の形態を為す近接照射療法シードを用い
る処置を含む。化学的処置手段のリスト１０８は、エタノールを用いる処置、ソ
トラデコールを用いる処置、酸を用いる処置、塩基を用いる処置、様々な化合物
を用いる処置、様々な化学薬品の混合物を用いる処置、触媒を用いる処置、組織
試料の外側をシールするシーリング剤を用いる処置、及び光またはレーザーシス
テムと共に使用される光反応性化学物質を用いる処置を含む。本発明の他の実施
態様は、組織試料にダメージを与えるのに適したあらゆる化学的処置システムを
用いることができる。The list 104 of mechanical treatment means includes deduplication devices and other cutting devices.
The list of ionizing radiation treatment means 106 includes treatments using X-rays, including X-ray needles, treatments using gamma rays, and treatments using brachytherapy seeds in the form of ionizing radiation directors. The list of chemical treatments 108 includes treatments with ethanol, treatments with sotradecol, treatments with acids, treatments with bases, treatments with various compounds, treatments with mixtures of various chemicals, treatments with catalysts Treatment with a sealant that seals the outside of the tissue sample, and treatment with a photoreactive chemical used with a light or laser system. Other embodiments of the present invention can use any chemical treatment system suitable for damaging a tissue sample.

【００３５】 次に、図５を参照すると、組織試料の単離並びにダメージング装置２００は、
作用部２０４にレーザー装置２０２を有している。このレーザー装置２０２は、
熱処置を通じて組織試料にダメージを与える。本発明の図示された実施態様は、
外向きに円弧状に撓んだ２つの切断用ワイヤー２０６を有している。本発明の実
施態様は、組織試料にダメージを与えるための処置手段の如何に関わらず、１つ
もしくはそれ以上の切断用ワイヤー２０６を有していてよい。本装置２００の遠
位側端部２１２には切断用先端部２１０が配置されていることに注意のこと。Next, referring to FIG. 5, the tissue sample isolation and damage device 200 includes:
The action section 204 has a laser device 202. This laser device 202
Damage tissue samples through heat treatment. The illustrated embodiment of the present invention includes:
It has two cutting wires 206 bent outward in an arc shape. Embodiments of the present invention may include one or more cutting wires 206 regardless of the treatment means for damaging the tissue sample. Note that a cutting tip 210 is located at the distal end 212 of the device 200.

【００３６】 次に、図６を参照すると、組織試料の単離並びにダメージング装置２２０は、
作用部２２４に細分化除去装置２２２を有している。この細分化除去装置２２２
を用いて組織試料が細分化除去される。その組織試料をカプセル化した後に、そ
の組織試料を細分化除去してもよい。組織試料のカプセル化は、図９に示されて
いるような組織試料カプセル化装置を用いることにより達成することができる。
図９は、棒状アセンブリ３１２、シース３１４、及びガイドアセンブリ３１６か
らなる組織試料カプセル化装置３１０を描いている。この棒状アセンブリ３１２
は、軸３１８と軸方向３２０、及び複数の半径方向３２２を定めている。また、
この棒状アセンブリ３１２は、図９の左側に示されている近位側端部３２４と、
図９の右側に示されている遠位側端部３２６を有している。それらの端部３２４
及び３２６間に中央セクション３２８が延在している。近位側端部３２４は、装
置３１０のユーザーにより保持される側の端部である。その近位側端部３２４は
、ユーザー（図示せず）の指示通りに装置３１０を操縦するコントロールボック
スまたはそれと同等なもの等のアクチュエーターシステムに機能的に接続されて
いてよい。一方、遠位側端部３２６は、標的体（図示せず）に挿入され、本装置
によりカプセル化されるべき組織試料の近傍にまで挿入される。棒状アセンブリ
３１２は、剛性または可撓性であってよく、そして、操作できるように関節式に
連結可能であってよい。この棒状アセンブリ３１２は、シャフトコア３２９、シ
ャフト３３０、シーススリーブ３３２、及び外側スリーブ３３４からなっている
。シャフトコア３２９、シャフト３３０、及び２つのスリーブ３３２及び３３４
は共軸的に配列されており、シャフトコア３２９がシャフト３３０の内側になり
、シャフト３３０がシーススリーブ３３２の内側になり、シーススリーブ３３２
が外側スリーブ３３４の内側になるように入れ子式に配列されている。シャフト
コア３２９とシャフト３３０は、２つのスリーブ３３２及び３３４を越えて近位
方向及び遠位方向に伸びており、更に、シャフトコアはシャフトを越えて近位方
向に伸びている。また、近位方向ではシーススリーブ３３２が外側スリーブ３３
４を越えて伸びているが、遠位方向では外側スリーブ３３４がシーススリーブ３
３２を越えて伸びている。図示されている装置では、本装置の遠位側端部３２６
は先端部３３８を有しており、この先端部３３８は、該先端部を横切って直径方
向に伸びる高周波（「ＲＦ」）活性化メンバー３４０を備えている。このＲＦ活
性化メンバー３４０をエネルギー活性化して、切除部または電気外科的切開部を
介して本装置を組織中に移動させ、これにより、カプセル化されるべき組織試料
を包含する標的体へ本装置を挿入できるようにしてもよい。また、レーザーまた
は他の集束光線技術、高圧水、鋭利な器具を用いての切断、寒冷技術等の他の手
段を介して本装置を生物学的標的に進入させてもよい。更に、本装置は、ＲＦ活
性化メンバー３４０に類似したコンポーネントを持っていなくてもよく、すでに
ある通路（図示せず）を通じて標的体に遠位側端部３２６を挿入してもよい。ま
た、本装置は、棒状アセンブリ３１２の近位側端部３２４から伸びるシース展開
ロッド展開端部３４２も有している。このシース展開メンバー展開端部３４２は
、組織試料の周囲でシース３１４を展開するため、軸方向３２０において近位方
向に引っ張られる。図１０には、組織試料４９１の周囲で展開されたシース展開
メンバー４４８が示されている。棒状部４１２の軸中心にシース展開メンバー展
開ロッド４５６が設けられている。このシース展開メンバー展開ロッド４５６は
、シース展開メンバーキャップ４５４を通じて遠位方向に伸びており、ストッパ
ー４８８で終結している。このストッパー４８８は、キャップ先端部４７６に隣
接して遠位側に配置されている。シース展開メンバーキャップ４５４は、近位方
向に伸びる軸方向伸張部４７８を有する状態で、棒状アセンブリ４１２の遠位側
端部４２６に配置されている。それらの軸方向伸張部４７８は、シャフトコア４
２９の内面に接触して配置されている。シース展開メンバー展開端部４７４は、
シース展開メンバーリング４８２の周囲でループを形成しており、キャップ先端
部４７６の近位側に配置されている。シース展開メンバー４４８は、シース展開
メンバーリング４８２から伸び、且つシャフト４３０の遠位側端部４２６から円
弧状に（radially）伸びている。図１０に示されているように、シース展開メン
バー展開ロッド４５６は、シャフトコア４２９内の中心に配置されている。シャ
フトコア４２９の外面に設けられた溝４５８にはプッシュロッド４５２が配置さ
れている。シャフト４３０はシャフトコア４２９を取り巻いている。組織試料４
９２は、シャフトの遠位側端部４２６に向けてシャフト４３０の周囲に配置され
ている。図示の如く、外側スリーブ４３４は、シャフト４３０を取り巻き、組織
試料４９２から近位方向に配置されている。シース４１４は、第二の部分４４６
が外側スリーブの下から遠位方向に伸びた状態で、シャフト４３０と外側スリー
ブ４３４の間に配置されている。シース展開メンバー４４８は、組織試料４９２
の周囲で展開されるが、棒状アセンブリ４１２から解放されてはいない。シース
展開メンバー４４８のエンドボール４７０はボール−ホルダー４６６内に配置さ
れている。プッシュロッド４５２がボール用開口４０２の近位側位置に押し込ま
れている。それらのボール用開口４０２は、各シース展開メンバースロット４７
２の近位側端部に配置されており、シャフト４３０を通じて伸びている。それら
のボール用開口４０２は、一般的に、組織試料４９２の近位側端部と相応する。
シース展開メンバー４４８は、エンドボール４７０から伸び、ボール用開口４０
２を通り、シースの第二の部分４４６から伸びる結紮部４４９を通じて組織試料
４９２の周囲の周辺縁４９８へ至る。Referring now to FIG. 6, the tissue sample isolation and damaging device 220 comprises:
The action section 224 has a subdivision removing device 222. This subdivision removing device 222
Is used to fragment the tissue sample. After encapsulating the tissue sample, the tissue sample may be minced and removed. Tissue sample encapsulation can be achieved by using a tissue sample encapsulation device as shown in FIG.
FIG. 9 depicts a tissue sample encapsulation device 310 consisting of a rod assembly 312, a sheath 314, and a guide assembly 316. This rod assembly 312
Defines an axis 318, an axial direction 320, and a plurality of radial directions 322. Also,
The rod assembly 312 includes a proximal end 324 shown on the left side of FIG.
It has a distal end 326 shown on the right side of FIG. Their ends 324
A central section 328 extends between and 326. Proximal end 324 is the end of device 310 that is held by the user. The proximal end 324 may be operatively connected to an actuator system, such as a control box or the like, that steers the device 310 as directed by a user (not shown). The distal end 326, on the other hand, is inserted into a target body (not shown) and into the vicinity of the tissue sample to be encapsulated by the device. The bar assembly 312 may be rigid or flexible and may be operably articulatable. The rod-shaped assembly 312 includes a shaft core 329, a shaft 330, a sheath sleeve 332, and an outer sleeve 334. Shaft core 329, shaft 330, and two sleeves 332 and 334
Are coaxially arranged, with the shaft core 329 inside the shaft 330, the shaft 330 inside the sheath sleeve 332, and the sheath sleeve 332.
Are nested such that are inside the outer sleeve 334. Shaft core 329 and shaft 330 extend proximally and distally beyond the two sleeves 332 and 334, and the shaft core extends proximally beyond the shaft. In the proximal direction, the sheath sleeve 332 is
4, but in the distal direction the outer sleeve 334 is
It extends beyond 32. In the device shown, the distal end 326 of the device is shown.
Has a tip 338 that includes a radio frequency ("RF") activation member 340 extending diametrically across the tip. The RF-activated member 340 is energy activated to move the device into tissue via an excision or electrosurgical incision, thereby allowing the device to be moved to a target body containing a tissue sample to be encapsulated. May be inserted. The device may also be entered into the biological target via other means such as laser or other focused beam technology, high pressure water, cutting with sharp instruments, refrigeration technology, and the like. Further, the device may not have components similar to the RF activation member 340, and may insert the distal end 326 into the target body through an existing passage (not shown). The device also has a sheath deployment rod deployment end 342 that extends from the proximal end 324 of the rod assembly 312. The sheath deployment member deployment end 342 is pulled proximally in the axial direction 320 to deploy the sheath 314 around the tissue sample. FIG. 10 shows a sheath deployment member 448 deployed around a tissue sample 491. A sheath deployment member deployment rod 456 is provided at the axial center of the rod portion 412. The sheath deployment member deployment rod 456 extends distally through the sheath deployment member cap 454 and terminates at a stop 488. The stopper 488 is located distally adjacent the cap tip 476. A sheath deployment member cap 454 is disposed at the distal end 426 of the rod assembly 412 with a proximally extending axial extension 478. The axial extensions 478 are
29 is arranged in contact with the inner surface. The sheath deployment member deployment end 474 is
A loop is formed around the sheath deployment member ring 482 and is located proximal to the cap tip 476. Sheath deployment member 448 extends from sheath deployment member ring 482 and extends radially from distal end 426 of shaft 430. As shown in FIG. 10, the sheath deployment member deployment rod 456 is centrally located within the shaft core 429. A push rod 452 is disposed in a groove 458 provided on the outer surface of the shaft core 429. Shaft 430 surrounds shaft core 429. Tissue sample 4
92 is disposed about the shaft 430 toward the distal end 426 of the shaft. As shown, outer sleeve 434 surrounds shaft 430 and is positioned proximally from tissue sample 492. Sheath 414 includes second portion 446
Is disposed between the shaft 430 and the outer sleeve 434 with a distal end extending below the outer sleeve. Sheath deployment member 448 can be used to
, But not released from the rod assembly 412. End ball 470 of sheath deployment member 448 is located within ball-holder 466. A push rod 452 is pushed into a position proximal to the ball opening 402. These ball openings 402 are provided in each sheath deployment member slot 47.
2 is located at the proximal end and extends through the shaft 430. The ball openings 402 generally correspond to the proximal end of the tissue sample 492.
The sheath deployment member 448 extends from the end ball 470 and the ball opening 40.
2 through a ligature 449 extending from the second portion 446 of the sheath to a peripheral edge 498 around the tissue sample 492.

【００３７】 組織試料は、非生物分解性材料もしくは生物分解性材料でカプセル化されてよ
い。本発明のこの実施態様では穴開け用ツールがないことに注意のこと。他の細
分化除去装置が穴開け用ツールを有していてもよい。また、切断用ワイヤーは引
っ込められた位置にあり、見えていないことにも注意のこと。[0037] The tissue sample may be encapsulated in a non-biodegradable or biodegradable material. Note that there is no drilling tool in this embodiment of the invention. Other deduplication devices may have a drilling tool. Also note that the cutting wire is in the retracted position and is not visible.

【００３８】 本発明の一つの実施態様では、組織試料は、カプセル化によりダメージが与え
られる。そのダメージは、組織試料が周辺組織から物理的に単離された結果であ
る。本発明の一つの実施態様では、シースは、組織試料（図示せず）を少なくと
も部分的に取り囲んでいてよい。本発明の別の実施態様（図示せず）では、組織
試料の周囲の外縁溝に流入し、その試料の外面をシールする化学物質を用いてな
されるカプセル化により、当該組織試料を物理的に単離してよい。シーリング用
化学物質の連続的な分布を確実化するためには、外縁溝の加圧等、当分野で既知
の適当な技術を用いることができる。In one embodiment of the invention, the tissue sample is damaged by encapsulation. The damage is the result of the tissue sample being physically isolated from surrounding tissue. In one embodiment of the invention, the sheath may at least partially surround a tissue sample (not shown). In another embodiment of the invention (not shown), the tissue sample is physically encased by encapsulation using a chemical that flows into the perimeter groove around the tissue sample and seals the outer surface of the sample. May be isolated. To ensure continuous distribution of the sealing chemical, any suitable technique known in the art, such as pressurization of the outer groove, can be used.

【００３９】 次に、図７を参照すると、組織試料の単離並びにダメージング装置２４０は、
作用部２４４に出口２４２を有している。それらの出口２４２は、化学物質が組
織試料に流入するのを可能にし、これにより、化学反応または他の化学的処理を
通じて組織試料を形質転換する。組織試料の単離は、周辺組織へ移入する化学物
質の量を低減する。Next, referring to FIG. 7, the tissue sample isolation and damage device 240 comprises:
The action part 244 has an outlet 242. These outlets 242 allow chemicals to flow into the tissue sample, thereby transforming the tissue sample through a chemical reaction or other chemical treatment. Isolation of a tissue sample reduces the amount of chemical that migrates to surrounding tissue.

【００４０】 本発明の他の実施態様では、作用部２４４から中空針が伸びていて、化学物質
をそれらの針を通じて組織試料に注入できるようになっていてよい。本発明の他
の実施態様は、棒状部２４６と接触している組織試料の表面にスリットを作るス
ライス用ツール含んでいてよい。それらのスリットは、化学物質の注入を促進す
る。また、それらのスリットを切断用ワイヤー２４８で作ってもよい。切断用ワ
イヤー２４８は回転し、且つ組織試料の単離前、もしくは単離後に周期的な間隔
で組織試料内へ部分的に伸ばされる。In another embodiment of the present invention, hollow needles may extend from the working portion 244 so that chemicals can be injected into the tissue sample through the needles. Other embodiments of the present invention may include a slicing tool that creates a slit in the surface of the tissue sample in contact with the rod 246. These slits facilitate the injection of chemicals. Also, those slits may be made with the cutting wire 248. The cutting wire 248 rotates and is partially extended into the tissue sample at periodic intervals before or after isolation of the tissue sample.

【００４１】 次に、図８を参照すると、組織試料の単離並びにダメージング装置２６０は、
棒状部２６６の作用部２６４に配置された組織試料２６２を低温で処置する。寒
冷流体は、供給ライン２６８を通じて作用部２６４へ流され、帰還ライン２７０
を介してコントロールシステム（図示せず）へ戻される。供給ラインと帰還ライ
ンは共に棒状部２６６内に配置されている。組織試料２６２は、その寒冷流体を
用いる熱的な処置により凍結され、ダメージが与えられる。Next, referring to FIG. 8, the tissue sample isolation and damage device 260
The tissue sample 262 placed on the action section 264 of the rod section 266 is treated at a low temperature. The cold fluid is flowed through the supply line 268 to the working section 264 and the return line 270
To a control system (not shown). The supply line and the return line are both arranged in the bar 266. The tissue sample 262 is frozen and damaged by the thermal treatment using the cold fluid.

【００４２】 本発明の実施態様は、組織試料の単離並びにダメージング装置に組み込まれた
適当なコントロールシステムを有している。更に、本発明のそれらの実施態様は
、異なる処置法及び異なる組織試料の形またサイズに合わせて適当に形成される
。Embodiments of the present invention have a suitable control system incorporated into the tissue sample isolation and damage device. Further, those embodiments of the present invention are suitably shaped for different procedures and different tissue sample shapes or sizes.

【００４３】 これまで、前述の部分において、本発明の好適な実施態様を詳細に説明してき
たが、当業者にとって明らかな、ここに教示された本発明の基本的な概念の多く
の変形態様及び／又は変更態様も、添付の特許請求項で定義されている通りの本
発明の精神及び範囲の中に含まれることを明白に理解すべきである。Having described in detail the preferred embodiments of the invention in the preceding part, many variations of the basic concepts of the invention taught herein, which will be apparent to those skilled in the art, It should be expressly understood that variations and / or modifications are within the spirit and scope of the invention as defined in the appended claims.

【図面の簡単な説明】[Brief description of the drawings]

【図１】 本発明の一つの実施態様による高周波エネルギー活性化ワイヤー
を用いる組織試料の単離並びにダメージング装置の側面図を示している。FIG. 1 illustrates a side view of a tissue sample isolation and damaging device using a radio frequency energy activation wire according to one embodiment of the present invention.

【図２】 組織試料の単離後で、その組織試料にダメージを与える前の、乳
房内に配置された図１の装置の断面図を示している。FIG. 2 shows a cross-sectional view of the device of FIG. 1 placed in a breast after isolation of the tissue sample and before damaging the tissue sample.

【図３】 熱処置により組織試料にダメージを与えた後である点を除き、図
２が示しているのと同じ断面図を示している。FIG. 3 shows the same cross-sectional view as FIG. 2, except after the tissue sample has been damaged by the thermal treatment.

【図４】 本発明の実施態様による、組織試料にダメージを与えるための処
置法の包括的図表である。FIG. 4 is a comprehensive diagram of a procedure for damaging a tissue sample, according to an embodiment of the present invention.

【図５―図８】 本発明の様々な実施態様による組織試料の単離並びにダメ
ージング装置の側面図である。5-8 are side views of a tissue sample isolation and damaging device according to various embodiments of the present invention.

【図９及び図１０】 本発明と共に使用し得る組織試料カプセル化装置を示
している。9 and 10 show a tissue sample encapsulation device that can be used with the present invention.

【手続補正書】特許協力条約第３４条補正の翻訳文提出書[Procedural Amendment] Submission of translation of Article 34 Amendment

【提出日】平成１２年１２月２８日（２０００．１２．２８）[Submission date] December 28, 2000 (2000.12.28)

【手続補正１】[Procedure amendment 1]

【補正対象書類名】明細書[Document name to be amended] Statement

【補正対象項目名】特許請求の範囲[Correction target item name] Claims

【補正方法】変更[Correction method] Change

【補正の内容】[Contents of correction]

【特許請求の範囲】[Claims]

───────────────────────────────────────────────────── フロントページの続き (51)Int.Cl.7 識別記号 ＦＩ テーマコート゛(参考） Ａ６１Ｂ 18/18 Ａ６１Ｂ 17/36 ３５０ 18/20 17/39 ３２０ (81)指定国 ＥＰ(ＡＴ，ＢＥ，ＣＨ，ＣＹ， ＤＥ，ＤＫ，ＥＳ，ＦＩ，ＦＲ，ＧＢ，ＧＲ，ＩＥ，Ｉ Ｔ，ＬＵ，ＭＣ，ＮＬ，ＰＴ，ＳＥ)，ＯＡ(ＢＦ，ＢＪ ，ＣＦ，ＣＧ，ＣＩ，ＣＭ，ＧＡ，ＧＮ，ＧＷ，ＭＬ， ＭＲ，ＮＥ，ＳＮ，ＴＤ，ＴＧ)，ＡＰ(ＧＨ，ＧＭ，Ｋ Ｅ，ＬＳ，ＭＷ，ＳＤ，ＳＬ，ＳＺ，ＴＺ，ＵＧ，ＺＷ )，ＥＡ(ＡＭ，ＡＺ，ＢＹ，ＫＧ，ＫＺ，ＭＤ，ＲＵ， ＴＪ，ＴＭ)，ＡＥ，ＡＬ，ＡＭ，ＡＴ，ＡＵ，ＡＺ， ＢＡ，ＢＢ，ＢＧ，ＢＲ，ＢＹ，ＣＡ，ＣＨ，ＣＮ，Ｃ Ｒ，ＣＵ，ＣＺ，ＤＥ，ＤＫ，ＤＭ，ＥＥ，ＥＳ，ＦＩ ，ＧＢ，ＧＤ，ＧＥ，ＧＨ，ＧＭ，ＨＲ，ＨＵ，ＩＤ， ＩＬ，ＩＮ，ＩＳ，ＪＰ，ＫＥ，ＫＧ，ＫＰ，ＫＲ，Ｋ Ｚ，ＬＣ，ＬＫ，ＬＲ，ＬＳ，ＬＴ，ＬＵ，ＬＶ，ＭＡ ，ＭＤ，ＭＧ，ＭＫ，ＭＮ，ＭＷ，ＭＸ，ＮＯ，ＮＺ， ＰＬ，ＰＴ，ＲＯ，ＲＵ，ＳＤ，ＳＥ，ＳＧ，ＳＩ，Ｓ Ｋ，ＳＬ，ＴＪ，ＴＭ，ＴＲ，ＴＴ，ＴＺ，ＵＡ，ＵＧ ，ＵＺ，ＶＮ，ＹＵ，ＺＡ，ＺＷ Ｆターム(参考） 4C026 AA04 4C060 EE03 EE17 EE19 JJ01 JJ11 JJ29 KK03 KK04 KK16 ──────────────────────────────────────────────────続 き Continued on the front page (51) Int.Cl. 7 Identification symbol FI Theme coat ゛ (Reference) A61B 18/18 A61B 17/36 350 18/20 17/39 320 (81) Designated country EP (AT, BE, CH, CY, DE, DK, ES, FI, FR, GB, GR, IE, IT, LU, MC, NL, PT, SE), OA (BF, BJ, CF, CG, CI, CM, GA, GN, GW, ML, MR, NE, SN, TD, TG), AP (GH, GM, KE, LS, MW, SD, SL, SZ, TZ, UG, ZW), EA (AM, AZ, BY) , KG, KZ, MD, RU, TJ, TM), AE, AL, AM, AT, AU, AZ, BA, BB, BG, BR, BY, CA, CH, CN, CR, CU CZ, DE, DK, DM, EE, ES, FI, GB, GD, GE, GH, GM, HR, HU, ID, IL, IN, IS, JP, KE, KG, KP, KR, KZ, LC , LK, LR, LS, LT, LU, LV, MA, MD, MG, MK, MN, MW, MX, NO, NZ, PL, PT, RO, RU, SD, SE, SG, SI, SK, SL, TJ, TM, TR, TT, TZ, UA, UG, UZ, VN, YU, ZA, ZWF terms (reference) 4C026 AA04 4C060 EE03 EE17 EE19 JJ01 JJ11 JJ29 KK03 KK04 KK16

Claims (9)

【特許請求の範囲】[Claims] 【請求項１】 周辺組織内の組織試料を処置するための装置であって、当該
装置が： ａ． 作用部； ｂ． 上記作用部に配置された組織試料単離用ツール；及び ｃ． 上記作用部に配置された組織試料ダメージャー； を含むことを特徴とする処置装置。1. An apparatus for treating a tissue sample in a surrounding tissue, the apparatus comprising: a. Working part; b. A tissue sample isolation tool disposed in the working section; and c. A tissue sample damageer arranged in the action section; 【請求項２】 更に、上記組織試料単離用ツールに機能的に接続された高周
波発生源を含んでいることを特徴とする、請求項１記載の処置装置。2. The treatment apparatus according to claim 1, further comprising a radio frequency source operatively connected to the tissue sample isolation tool. 【請求項３】 上記組織試料単離用ツールが、上記作用部の周囲に外方へ円
弧状に撓んだ位置へ拡張可能な切断メンバーを含んでいることを特徴とする、請
求項１記載の処置装置。3. The tissue sample isolation tool according to claim 1, wherein the tissue sample isolation tool includes a cutting member that is expandable to an outwardly arcuately bent position around the working portion. Treatment equipment. 【請求項４】 更に、上記切断メンバーに機能的に接続された切断メンバー
高周波発生源を含んでいることを特徴とする、請求項３記載の処置装置。4. The treatment device of claim 3, further comprising a cutting member radio frequency source operatively connected to said cutting member. 【請求項５】 上記組織試料ダメージャーが、上記作用部から伸び、且つ、
金属メンバー高周波発生源に機能的に接続可能な少なくとも１つの金属メンバー
を含んでいることを特徴とする、請求項４記載の処置装置。5. The tissue sample damageer extends from the action section, and
5. The treatment device according to claim 4, wherein the treatment device includes at least one metal member operably connected to the metal member high-frequency source. 【請求項６】 上記組織試料ダメージャーが電離放射線導波器を含んでいる
ことを特徴とする、請求項１記載の処置装置。6. The treatment apparatus according to claim 1, wherein the tissue sample damager includes an ionizing radiation director. 【請求項７】 上記組織試料ダメージャーが組織試料カッターを含んでいる
ことを特徴とする、請求項１記載の処置装置。7. The treatment device according to claim 1, wherein the tissue sample damager includes a tissue sample cutter. 【請求項８】 上記組織試料ダメージャーが熱処置システムを含んでいるこ
とを特徴とする、請求項１記載の処置装置。8. The treatment device according to claim 1, wherein the tissue sample damager includes a heat treatment system. 【請求項９】 上記組織試料ダメージャーが化学物質導入システムを含んで
いることを特徴とする、請求項１記載の処置装置。9. The treatment apparatus according to claim 1, wherein the tissue sample damager includes a chemical substance introduction system.
JP2000595601A 1999-01-27 2000-01-25 Tissue sample isolation and damage apparatus and method Pending JP2002535069A (en)

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US8636734B2 (en) 2014-01-28
AU2634200A (en) 2000-08-18
US20140180163A1 (en) 2014-06-26
US6659105B2 (en) 2003-12-09
US20080281323A1 (en) 2008-11-13
US6676658B2 (en) 2004-01-13
US20010039420A1 (en) 2001-11-08
CA2360582A1 (en) 2000-08-03
EP1733690A2 (en) 2006-12-20
US7357801B2 (en) 2008-04-15
US9510809B2 (en) 2016-12-06
US20040204709A1 (en) 2004-10-14
EP1146828A1 (en) 2001-10-24
US20010017137A1 (en) 2001-08-30
WO2000044295A1 (en) 2000-08-03
US20170079626A1 (en) 2017-03-23

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